典藏书目

Taiyin Channel diseases have historically been discussed in a confused manner, leading to frequent errors in the application of prescriptions and herbs. Upon careful examination, there are three distinct therapeutic approaches. Pathogenic factors affecting the Taiyin may be transmitted from other channels (Chuanjing), strike directly (Zhizhong), or sink inward due to improper purgation (Wuxia Neixian); these must not be confused.

For instance, as stated in the classics, "abdominal fullness and dry throat" indicates Yang pathogenic factors transmitted via channels. The appropriate treatment is Xiao Chai Hu Tang (Minor Bupleurum Decoction) with Ginseng removed and Shaoyao added to harmonize. If this fails, a purgative method should be employed. The classics also state: "abdominal fullness with vomiting, inability to eat, worsening diarrhea, and spontaneous abdominal pain at times," which indicates Cold pathogenic factors striking directly. The appropriate treatment is Lizhong Tang (Regulate the Middle Decoction) to warm the interior. Furthermore, regarding Taiyang channel disease where the physician erroneously applied purgation, resulting in abdominal fullness and intermittent pain, this indicates pathogenic factors sinking inward due to improper purgation. The treatment should be Guizhi Jia Shaoyao Tang (Cinnamon Twig Decoction plus Paeonia). In cases of severe excess pain (Dashitong), Guizhi Jia Dahuang Tang (Cinnamon Twig Decoction plus Rheum) is used. Thus, we know that transmitted pathogenic factors are best treated with formulas such as Da Chai Hu Tang (Major Bupleurum Decoction) and Xiao Chai Hu Tang; directly striking pathogenic factors are treated with Lizhong Tang; and pathogenic factors sinking inward due to improper purgation are treated with modified Guizhi Tang.

Now, let us discuss cases transmitted to the Taiyin channel and their manifestations: abdominal fullness and pain, dry throat, and a deep, forceful pulse. The primary prescription is Da Chai Hu Tang. If accompanied by diarrhea, remove Dahuang and add Huanglian to clear heat.

Prescription Composition: Chaihu (1.5 qian), Banxia (washed, 0.7 qian), Huangqin, Shaoyao (each 2 qian), Zhishi (1 qian), Dahuang (2 qian). Decoct in water and take orally.
If accompanied by alternating chills and fever, add Shengjiang (0.5 qian) and Dazao (3 pieces).

Question: Why is abdominal fullness and pain considered a Taiyin syndrome?
Answer: The Spleen corresponds to Kun Earth, and Kun represents the abdomen; it is the extreme Yin within Yin. When pathogenic factors transmit here, abdominal fullness and pain occur.

Another question: Since abdominal pain is a Interior syndrome, why use Dahuang for purgation but first employ Chaihu and Shaoyao?
Answer: This is caused by Shaoyang pathogenic factors transmitting into the Taiyin. When Shaoyang pathogens enter the Taiyin, Liver Wood overacts on Spleen Earth, resulting in abdominal pain. Therefore, Chaihu and Shaoyao are used to harmonize. For severe pain, Dahuang is added to purge. Similarly, in Taiyang disease, if improper purgation causes pathogens to sink inward resulting in abdominal pain, Guizhi Jia Shaoyao Tang is used; for severe excess pain, Guizhi Jia Dahuang Tang is used. The intent is consistent. However, although abdominal pain belongs to the Taiyin category, there is a distinction between transmitted and direct strike pathogens. Generally, transmitted pathogens enter from the Three Yang channels, while direct strike pathogens arrive suddenly. Transmitted pathogens present with a deep, forceful pulse; direct strike pathogens present with a deep, fine pulse. Transmitted pathogens cause dry throat and mouth; direct strike pathogens cause cold breath from the mouth and nose. These serve as differentiating criteria.